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Journal of Clinical Microbiology, October 1998, p. 2893-2899, Vol. 36, No. 10
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Prolonged Replication of a Type 1 Vaccine-Derived Poliovirus in an Immunodeficient Patient

Olen M. Kew,1,* Roland W. Sutter,2 Baldev K. Nottay,1 Michael J. McDonough,1 D. Rebecca Prevots,3 Linda Quick,2 and Mark A. Pallansch1

Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases,1 and Divisions of Eradication of Vaccine-Preventable Diseases2 and Epidemiology and Surveillance,3 National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333

Received 11 March 1998/Returned for modification 5 June 1998/Accepted 26 June 1998

VP1 sequences were determined for poliovirus type 1 isolates obtained over a 189-day period from a poliomyelitis patient with common variable immunodeficiency syndrome (a defect in antibody formation). The isolate from the first sample, taken 11 days after onset of paralysis, contained two poliovirus populations, differing from the Sabin 1 vaccine strain by ~10%, differing from diverse type 1 wild polioviruses by 19 to 24%, and differing from each other by 5.5% of nucleotides. Specimens taken after day 11 appeared to contain only one major poliovirus population. Evolution of VP1 sequences at synonymous third-codon positions occurred at an overall rate of ~3.4% per year over the 189-day period. Assuming this rate to be constant throughout the period of infection, the infection was calculated to have started ~9.3 years earlier. This estimate is about the time (6.9 years earlier) the patient received his last oral poliovirus vaccine dose, approximately 2 years before the diagnosis of immunodeficiency. These findings may have important implications for the strategy to eliminate poliovirus immunization after global polio eradication.

* Corresponding author. Mailing address: Respiratory and Enteric Viruses Branch, G-10, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333. Phone: (404) 639-3940. Fax: (404) 639-2648. E-mail: omk1{at}cdc.gov.

Journal of Clinical Microbiology, October 1998, p. 2893-2899, Vol. 36, No. 10
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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